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Innovation and Ecosystem “Why great innovations fail: It's all in the Ecosystem” 2 JASON Report* “EHRs should not be things that one buys, but rather things that evolve through cultural change aided by technology” *A Robust Health Data Infrastructure JASON Report: November 2013 Forbes-2012 The Wide Lens: A New Strategy for Innovation By Ron Adner of Dartmouth

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Open Source EHR Ecosystem Community Software Governance 3

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“Greatness on your part is not enough. You are no longer an autonomous innovator. You are now an actor within a broader innovation ecosystem. Success in a connected world requires that you manage your dependence. But before you can manage your dependence, you need to see it and understand it. ” Innovation Strategy is Organic to OS Operations 4 The Wide Lens: A New Strategy for Innovation By Ron Adner of Dartmouth CommunityGovernance Software

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Two Security Models 7 Open source operating systems such as Android & Linux offer the ability to implement security policies down to the kernel level. Complete Control of Implementation OPEN SOURCE Partial Control of Implementation TRUST US TRUST US PROPRIETARY

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Improves/ensures the quality of Open Source code Critical to making code reusable for code intake by the community NOT a replacement for acceptance, integration, or regression testing by new user organization Open Source Software Quality Certification 15

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Usable: Appropriate licensing and documentation Safe: Individual code units do not cause errors in other components of the system and the code is robust to all code paths and conditions Compliant: Code meets agreed upon interface specifications and code conventions, and complies with all applicable laws and regulations Functional: Code has a defined set of requirements that are met when the code executes Maintainable: Integral unit tests are provided to facilitate regression testing OSEHRA Certification Standard 16